Another step on our food allergy journey, Miss J (3yo) had her Baked Egg Challenge last week.
A Bit of Background on Miss J and Our Journey So Far
When Miss J was 5 months old she had an anaphylactic reaction to dairy. At her first skin prick tests for food allergies at 7 months her results showed that she was allergic to dairy, soy, egg white, egg yolk, peanuts, almonds, hazelnuts.
Since that test we have strictly avoided all of her allergens (she passed an oral challenge to soy, administered by me while sitting in local Emergency Dept, at 2.5 years). Of course there have been accidental exposures, mainly through other people touching/kissing her with allergens on their hands/faces. But ‘touch wood’ so far we have not had a severe reaction requiring the administration of her Epipens (she always has 2 with her).
In mid 2014 we moved from the Hunter Valley to my hometown of Warrnambool, to be closer to family so we could get some much needed support. Any other ‘allergy families’ reading this will know exactly what I mean, having a child with food allergies is stressful and isolating.
So we moved to Warrnambool, in South West Victoria. One of the big downfalls, apart from moving further away from hubby’s family in Sydney, was having to leave our allergist in Newcastle. He was brilliant, we felt very confident with him managing Miss J’s allergies.
Unfortunately there are no allergy specialists in Warrnambool, there is nowhere to get skin prick tests done, and no allergists/immunologists in town. The closest is 200km away. So I started researching options.
Finding Our New Allergist
One name kept popping up, Dr Joanne Smart at the Epworth Allergy Clinic. Everything I read on Dr Smart, from Facebook pages (Anaphylaxis & Allergy Friends Australia is a great page), to other blogs, and basically searching and reading online, was positive, more than positive, the reports were glowing.
Dr Smart is a Paediatric Allergist & Immunologist, she is one smart cookie, right on the front line of allergy & immunology specialists in Australia.
We had our first appointment with Dr Smart in July where Miss J had a new round of skin prick tests, her results showed some changes, some of her readings had got better, some had got worse, and some new ones had shown themselves.
When we met with Dr Smart after the tests she recommended that Miss J have a baked egg challenge, and after that a baked dairy challenge.
While Miss J’s egg reading was still quite high at 14, the fact that she has never eaten eggs was the deciding factor in conducting the challenge. Skin prick tests aren’t definitive, the only true indicator of being allergic is a food challenge, so we booked in.
Leading Into The Challenge
We have always discussed Miss J’s allergies with her, she knows that she can’t have cows milk, or eat eggs, peanuts, other nuts. She will sometimes bring it up and ask why she can’t have them and we will talk about it. And while I sometimes feel sad that she has to think about this stuff, at the tender age of 3, the fact that she has the knowledge and does think about her food allergies, encourages me for the future, as they say – Knowledge is Power!
On the Tuesday before our Friday appointment Miss J asked me out of the blue “Mumma will my muffins have eggs & peanuts in them?” I explained to her that it would only be eggs, and we ran through how the challenge would go. That Mumma & Dadda would be there with her, and the Doctors would be there too, that she would eat some of the muffins and see how she felt. She seemed ok with that explanation.
I baked the 12 muffins, to the Epworth recipe, at my parents house two nights before the challenge. I felt like a criminal buying the 6 pack of eggs, breaking open the eggs into the batter felt so wrong, but watching the muffins rise perfectly gave me a ray of hope, imagine if eggs were no longer the enemy, Miss J would have another safe food, and I could start baking with eggs again, cakes that rise perfectly, imagine!
We drove to Ballarat the afternoon before the challenge, as we had to be at the Epworth for an 815am start, with Warrnambool being about a 4 hour drive at that time of the day we thought it made more sense to stay at my sisters in Ballarat and only have a 1.5-2 hour trip.
Leading into the challenge hubby & I were realistic, yes we were hoping like hell that she would pass, but we both knew it was probably a 50/50 situation. We were prepared for things to go wrong, I had packed changes of clothes for all of us, as things can get messy in food challenges, with vomiting being an early indicator of things not going well.
The Day Of The Challenge
Miss J is usually a good traveller, however after about 15 mins of our 1.5 hour trip she kept saying “Dadda lets go back to Auntys house I forgot something”, which turned into “Someone turn this car around right now”, that chant continued till we got to the West Gate Bridge, and she was distracted by the cars, tall buildings and all the things a country kid is bewildered by on their 2nd ever trip to the big smoke!
We arrived at the Epworth with about half an hour to spare, which was excellent, we didn’t have to rush around, we had time to relax, for us all to take a big breath and prepare.
Sitting in reception were another two families there for a challenge, after a bit of a chat with one of the mums, we realised, we “knew” each other, in that way that bloggers “know” each other, we had both visited each others blogs and Facebook pages.
Their son Oliver of the Oliver’s Choice blog & Facebook page, was there for an almond challenge. You can read all about Oliver’s latest food challenge here. It’s time like this you do realise that it’s a small world, 6 degrees of separation and all that!
The Challenge – Egg Muffins
We were called into the challenge room at about 830am, and met the nurses who would be looking after us. Carol was our nurse, and straight away we had a good feeling from her. She had a lovely manner with Miss J, and made us all feel relaxed pretty much immediately. She ran through how things would happen. Increasing amounts of muffin given at 20 minute intervals, with regular monitoring throughout, checking vitals, skin for any welts/swelling etc.
She stressed to hubby & I that it was up to Miss J to describe how she was feeling, that we weren’t to lead her or put words in her mouth. Obviously she hadn’t Miss J before, this child has her own voice indeed!
I gave our 2 muffins to Carol, she returned with two small squares of muffin, 1/16th of a muffin. I fed those two small squares to Miss J using a spoon.
Immediately after swallowing, hubby (who was standing in front of us, I had Miss J between my legs sitting on the bed), said that Miss J started poking her tongue out and licking her lips. We thought it may have been just the new texture/flavour. I asked her how it was, she replied “Delicious can I have more cake”, we explained we had to wait a while.
About 2 minutes later she asked for water and said her mouth was tingly (immediately warning bells started going off in my head). Carol advised us to feed her some fruit and water, to help dilute the muffin.
Carol took her vitals again, no welts, no redness, all good. Miss J kept asking for more delicious cake. Then I noticed her take a gulp, I asked her how she felt. She replied that her tummy felt yukky, I asked if she meant toilet yukky. She said no, burpy yukky. Miss J calls vomiting, burping. Again hubby & I looked at each other knowing this wasn’t a great sign.
Within 2 minutes, Miss J had vomited all over the bed, and herself, and was very upset, she hates ‘the burps’. Carol and the other nurse stripped off the bed linen, as hubby & I stripped off Miss J.
Carol gave her the once over again, all her vitals were fine. Then Miss J vomited again, this time into a sick bag. Miss J got very agitated and cranky, which isn’t her, she was crying and wanting to leave, she was really out of sorts.
After more checks, and speaking to Dr Smart, Carol advised us that the challenge was over, Miss J was obviously highly allergic to egg, even in baked form, and gave us a syringe of Zyrtec to give to Miss J, which she took with some coaxing. Within about 5 minutes she was no longer agitated, she was still a bit teary, but very tired.
Within maybe 10 minutes, she was back to normal, happy, talking to everyone, laughing, playing, wanting to explore. That’s when hubby & I started to relax a bit. I stepped out of the curtain for a glass of water, and got a lovely, and very much needed hug from Oliver’s Mum, it was so lovely to speak to someone, at that moment of stress, and know they knew exactly how we were feeling, Oliver had previously failed an egg challenge also.
Carol asked hubby to take Miss J for a walk and to have some lunch, then come back after about 20 minutes. Miss J couldn’t have left the room quicker, she is an explorer, and loved going up & down in the escalator, on the stairs, basically wandering anywhere she could, outside of the room!
When they returned Carol checked Miss J’s stats again, all good. She was confident that she had vomited up all of the muffin, and that what may have been left in her system would be flushed through with nothing more than a yucky toilet trip.
Dr Smart came in and discussed the challenge with us, and we went right through everything Miss J had said during the challenge, how she had described how her body was feeling. I was so proud of Miss J being able to speak up so well for herself.
After The Challenge
So the challenge was a big fat Fail, but as Dr Smart & Carol advised, it was a “good fail”, she had reacted to the smallest dose they give, 1/16th of a muffin, which is the equivalent of 0.5g of egg (2x50g eggs split into 12 muffins, then 1/16th of 1 muffin = 0.5g). And her reaction had removed the allergen from her body, she was confident there would be no after effects.
We asked Dr Smart if there was anything extra we should be doing once we left the hospital. Her advice was to keep on doing what we’re doing, strict avoidance of all egg items, with a view to another challenge in 1-2 years. As all parents know, kids change so quickly, hopefully Miss J’s immune system changes enough in the next 1-2 years that she will be able to tolerate eggs at her next challenge!
We drove back to Ballarat after the challenge, Miss J slept the whole 75 min trip. After a few hours rest and play, dinner & a bath we loaded all our kit up and drove home, 2 hours to Warrnambool. We got home at 9pm, a very tired, emotionally drained family!
The next day at breakfast Miss J announced “No more eggy cake, ok Mumma”!!
Absolutely chickadee, absolutely xxx
Our next step, is a Baked Dairy Challenge at the end of November, wish us luck for that one!!!
I would love to hear from any other families who have been through food challenges with their allergic children.
Till next time,
Mel – This Happ-y Mumma
PS – If anyone local to Warrnambool would like 10 muffins, with egg in them, let me know!!